Is being diagnosed with lupus later in life associated with a greater risk of dying?

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The study aimed to determine the mortality rate, causes of death, and mortality risk factors in Turkish patients with systemic lupus erythematosus (SLE), including whether age at diagnosis was related to mortality.

Researchers retrospectively analyzed data from 221 patients followed for SLE in their department between January 1998 and March 2016. There were 10 males and 211 females; mean age was 41.5±13.5 years, with a range of 18 to 74 years. Detailed clinical findings, organ involvement, autoantibodies, and complement levels were recorded.

Overall, 19 patients (8.6%) died. The mortality incidence rate was 1.05 per 100 patient-years. The most frequent causes of death were infections, ischemic cardiovascular disease, and cerebrovascular disease.

In univariate analysis, older age at diagnosis and shorter follow-up duration were the only factors associated with mortality (p=0.004 and p=0.002, respectively). SLE organ involvement, autoantibodies, and antiphospholipid antibody syndrome were not found to be associated with mortality.

A further analysis compared late-onset SLE, defined as diagnosis at age 50 or above, with adult-onset SLE, defined as diagnosis before age 50. Survival was substantially shorter in the late-onset group (p=0.003). Cumulative five-year, 10-year, and 15-year survival rates were 91.9%, 90%, and 88.2%, respectively.

The researchers concluded that older age at diagnosis was a factor associated with mortality. They recommended closer and more meticulous follow-up for patients diagnosed at an older age than for those diagnosed earlier, in view of their mortality risk.